HomeMy WebLinkAbout1354 D~larAtbn ot Domicfl~ a~d ClttsMShlp -
TO THE STATE AND COUNTY TAX ASSESSOR. 154381
s~. iucie couNnr, ~oai~A: '
1'his is my dacluation of Domicile and Citizenship in ths Stat~ of Florida tMt I am fillnq this d~y in aooordsno~ and
in oonformity with Chapte? ~22. Settion 422.17, Floride StahiNs. ,
1 was forme~ly s laqal residsnt of ~aoh~oa~ill~ _ ~`1 eri ds
tC1tY) (Stat~) .
and I ~esided at 630 S~ab7~0o][ COV~ jtOad .~~vK 1 havt chan~d my domWk
(Sneet a~d Number) .
to and am and have besn a bona fids rasident of the Stat~ of Florida sinoe d~Y ~
ZO~A~b ~r , 19~, a~d I reside at $t 4 BOZ 102 -
(St~eet and Number)
FORT M~, SAINT LYCIE ~OUNTY, R,ORlDA
and thi: statement 1s to be taken as my dedaration of citize~ship, actual legal residenos and domidle In the Steh of HoNda.
pnsert here any pe~tinent facts, such aa aale of propery or business, or rolinquishn~nt of ~nnploym~M
at former domicile, removal of family ro new domiate, pu~chase of home, ~tc.)
~p~lJing ror hoae~t~ad
- - F~~o ~NO RECOROEfl _
sT. wc~E counr~r,
RECORD V~RIFIEO
- 154~1
~ ~ ~1 MAR 30 AN 1 I: y 0
~O~~R ~'OiTRAS
CLERK CIRCUIT COURT
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~ 1 FURTHER ~ERTIFY fhat I wii) oomply with all other requirem~nb of a lepal rosidsnt of this Stah.
I FURTHER CERTIFY that I have no intention to retum to my former domic,ile, and 1 intend to remain in FORT
: .
PtERCE, SAIt~Tti~l~~~~~~Y. FLORIDA, permanently. -
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S~worn to and subxribsd before me this a~th day of ~r~ - 19 6?.
ROOE1 rORRAS " _ .
CpURT Notary PuWk
.~.s.~.t~(iC~RCUI~ .
gY f% D.C. My Gommission snpires
(T~ i~ ~oo~aM«I M d~I1eaN aad ori~d filyd wilb Cf~k Ciew~it C~t, and d~plieal~ wiM~ T~c A~era
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